AML in patients under the age of 20

Selina M. Luger, MD

Last Modified: February 10, 2002

Question:

Dear OncoLink "Ask The Experts,"

My daughter is 18 and has AML M5. I understand this disease is more aggressive in people under 20. Where can I find treatments and long-term results for younger people? Most of the info I find does not differentiate.

Thank you.

Answer:

Selina M. Luger, MD, Director of the Leukemia Program and Assistant Professor of Medicine at the University of Pennsylvania, responds:

I am not certain where you have read that information, but I don't think it is accurate. The area can be confusing. There is no evidence that AML is any harder to treat in patients under the age of 20, and in general the younger an adult with AML, the more successful the long term outcome.

The bone marrow is the organ that is responsible for the normal manufacturing of blood cells. We have three different types of blood cells, white blood cells, red blood cells and platelets. Cells called stem cells in the bone marrow grow through various stages of development and mature into cells that make either (1) mature myeloid cells- white blood cells such as graunuloctes, red blood cells and platelets or (2) mature lymphoid cells-white blood cells called lymphocytes. Acute leukemia is a cancer of the bone marrow that results from the accumulation of cancerous immature cells, or blasts, and the subsequent reduction of mature normal blood cells. There are 2 basic forms of acute leukemia, (cancer of the bone marrow which results in a accumulation of cancerous immature cells). Acute leukemia can be either myeloid (arising from bone marrow cells that were destined to be myeloid) or lymphoid (arising from cells that are destined to be lymphoid). In children, most leukemias are lymphoid and the results in ALL appear better than the results for AML. In adults, most leukmias are myeloid.

I would recommend that you daughter be treated at an institution that treats a good number of leukemic patients. If there is a university hospital in your area, I would recommend that she be evaluated there.